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Tackling Mandatory CMS Orthopedic Bundling: Is Your Organization Prepared?


CMS is proposing a new, mandated payment model to support improved care for beneficiaries undergoing hip and knee replacements. Goals of this program include:

  • Driving financial and quality effort of the Comprehensive Care Joint Replacement (CCJR) episode of care led by the hospital
  • Increasing coordination of care among hospitals, physicians, and post-acute care (PAC) providers
  • Recognizing and adapting to CMS' goal to have 50% of payment as value-based by 2018

This CMS program has placed a burden on providers not faced before: understanding the total cost of patients' joint replacement and then managing the care of ALL providers in a high quality lost cost manner.

Join us for a 30-minute webcast, where PwC subject matter experts will provide insight into how to navigate the complexities associated with the new mandate, which takes effect on April 1, 2016, and share a framework and partnership methodology that has proven successful with a variety of alternative payment initiatives. PwC will also share research from its recently released report "Healthcare's Alternative Payment Landscape."



Warren Skea — Principal, Health Industries Advisory, PwC

With more than 20 years of industry-wide healthcare experience, Warren's background as a hospital administrator at an integrated health system has contributed to his expertise in the topics of physician alignment strategies, quality and performance improvement, and reimbursement methodologies. He is an extensively published researcher on the topics of emerging population health models such as Accountable Care Organizations (ACOs) - including a chapter on governance models in the Dartmouth-Brookings National ACO Toolkit. He has worked with several clients on their strategy, development and implementation of CMS Pioneer and MSSP Pilot sites programs as well as their commercial risk bearing contracts. Prior to joining PwC, Warren was the National Director of Performance and Quality Improvement Initiatives for the American Heart Association Corporate headquarters. Warren received his Ph.D. in health policy and quantitative methodology.


Joel Jaglin, MS, CPA, FACHE — Health Industries Advisory Director, PwC

Joel Jaglin is a Director in PwC's Health Industries Advisory Practice serving as a leader of the Deals, Growth and Strategy and Capital Projects and Infrastructure (CP&I) core teams. He has over 25 years of experience focused on provider strategic and tactical planning including clinical service line planning, hospital-physician alignment and integration; clinical operations planning; and mergers and integration. He has extensive experience working with health systems and physician practices around developing aligned incentives and joint ventures, a major driver of clinical integration in today's healthcare environment. He has spoken previously and written articles on health reform and the importance of health systems alignment with physicians. 

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